The effect of impaired glucose metabolism on weight loss in multidisciplinary childhood obesity treatment

TY - JOUR

T1 - The effect of impaired glucose metabolism on weight loss in multidisciplinary childhood obesity treatment

AU - Kloppenborg, Julie T.

AU - Gamborg, Michael

AU - Fonvig, Cilius E.

AU - Nielsen, Tenna R.H.

AU - Pedersen, Oluf

AU - Johannesen, Jesper

AU - Hansen, Torben

AU - Holm, Jens-Christian

N1 - Funding information The Novo Nordisk Foundation, Grant/Award number: NNF15OC0016544; Novo Nordisk, Grant/Award number: unrestricted educational grant; The Danish Innovation Foundation, Grant/Award number: 0603‐00457B; The Region Zealand Health Scientifics Research Foundation

PY - 2018

Y1 - 2018

N2 - OBJECTIVE: To investigate whether children and adolescents exhibiting an impaired glucose metabolism are more obese at treatment entry and less likely to reduce their degree of obesity during treatment.METHODS: The present study is a longitudinal observational study, including children and adolescents from the Children's Obesity Clinic, Holbaek, Denmark. Anthropometrics, pubertal development, socioeconomic status (SES), and fasting concentrations of plasma glucose, serum insulin, serum C-peptide, and whole blood glycosylated hemoglobin (HbA1c) were collected at treatment entry and at follow-up. Proxies of Homeostasis Model Assessment 2-insulin sensitivity (HOMA2-IS) and Homeostasis Model Assessment 2-β-cell function (HOMA2-B) were calculated with the Homeostasis Model Assessment 2 program.RESULTS: In total, 569 (333 boys) patients, median 11.5 years of age (range 6-22 years), and median body mass index (BMI) z-score 2.94 (range 1.34-5.54) were included. The mean BMI z-score reduction was 0.31 (±0.46) after 13 months (range 6-18) of treatment. At treatment entry, patients with impaired estimates of glucose metabolism were more obese than normoglycemic patients. Baseline concentration of C-peptide was associated with a lower weight loss during treatment in girls (P = .02). Reduction in the insulin concentrations was associated with reduction in BMI z-score in both sexes (P < .0001, P = .0005). During treatment, values of glucose, HbA1c, HOMA2-IS, and HOMA2-B did not change or impact the treatment outcome, regardless of age, sex, SES, or degree of obesity at treatment entry.CONCLUSION: The capability to reduce weight during multidisciplinary treatment in children and adolescents with overweight/obesity is not influenced by an impaired glucose metabolism at study entry or during the course of treatment.

AB - OBJECTIVE: To investigate whether children and adolescents exhibiting an impaired glucose metabolism are more obese at treatment entry and less likely to reduce their degree of obesity during treatment.METHODS: The present study is a longitudinal observational study, including children and adolescents from the Children's Obesity Clinic, Holbaek, Denmark. Anthropometrics, pubertal development, socioeconomic status (SES), and fasting concentrations of plasma glucose, serum insulin, serum C-peptide, and whole blood glycosylated hemoglobin (HbA1c) were collected at treatment entry and at follow-up. Proxies of Homeostasis Model Assessment 2-insulin sensitivity (HOMA2-IS) and Homeostasis Model Assessment 2-β-cell function (HOMA2-B) were calculated with the Homeostasis Model Assessment 2 program.RESULTS: In total, 569 (333 boys) patients, median 11.5 years of age (range 6-22 years), and median body mass index (BMI) z-score 2.94 (range 1.34-5.54) were included. The mean BMI z-score reduction was 0.31 (±0.46) after 13 months (range 6-18) of treatment. At treatment entry, patients with impaired estimates of glucose metabolism were more obese than normoglycemic patients. Baseline concentration of C-peptide was associated with a lower weight loss during treatment in girls (P = .02). Reduction in the insulin concentrations was associated with reduction in BMI z-score in both sexes (P < .0001, P = .0005). During treatment, values of glucose, HbA1c, HOMA2-IS, and HOMA2-B did not change or impact the treatment outcome, regardless of age, sex, SES, or degree of obesity at treatment entry.CONCLUSION: The capability to reduce weight during multidisciplinary treatment in children and adolescents with overweight/obesity is not influenced by an impaired glucose metabolism at study entry or during the course of treatment.

KW - Journal Article

KW - Body Mass Index

KW - Glucose Intolerance/blood

KW - Humans

KW - Insulin/blood

KW - Blood Glucose

KW - Male

KW - Prediabetic State/blood

KW - Pediatric Obesity/blood

KW - Young Adult

KW - Weight Loss

KW - Adolescent

KW - Female

KW - Glycated Hemoglobin A/metabolism

KW - C-Peptide/blood

KW - Weight Reduction Programs/statistics & numerical data

KW - Child

KW - Longitudinal Studies

KW - prediabetes

KW - weight loss

KW - children

KW - impaired glucose metabolism

KW - obesity

U2 - 10.1111/pedi.12605

DO - 10.1111/pedi.12605

M3 - Journal article

C2 - 29159854

SN - 1399-543X

VL - 19

SP - 366

EP - 374

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 3

ER -